Dr. Karen DeSalvo is a general internist and junior health services researcher at Tulane University Health Sciences Center in New Orleans. Her long-term goal is to develop an independent career as an applied health services researcher with a focus on improving health outcomes for disadvantaged populations with chronic disease. Dr. DeSalvo has developed a detailed 3-year career development plan to augment her training and experiences. These plans involve advanced coursework and an intensive, mentored research experience under the guidance of successful senior investigators. The mentorship team includes Dr. Jiang He (primary mentor), Dr. John Peabody (co-mentor), and Dr. Stephan Fihn (co-mentor). This application is designed to allow [unreadable] Dr. DeSalvo to successfully accomplish five career objectives: 1) obtain experience in the design and conduct of health services research in the context of mentored research projects; 2) advance her research skills in health related quality of life measurement, advanced analytic techniques, and risk [unreadable] adjustment through didactic training; 3) develop expertise in analyzing large survey databases such as the Medical Expenditure Panel Survey; 4) acquire research skills and experience necessary to lead multicenter, translatable research projects through close collaboration with mentors; 5) develop academic leadership skills and qualifications. The research component of this training award will advance the understanding of a single question measuring general self-rated health (GSRH) used in risk prediction as a tool to inform health care practice and policy. We assess the robustness of GSRH relative to established risk prediction tools, the performance of changes in GSRH relative to cross-sectional measures of GSRH and other risk prediction tools, and the determinants of changes in GSRH in disadvantaged population. We will use data from the 2001 Medical Expenditure Panel Survey (MEPS), a survey that captures GSRH, socioeconomic and demographic variables, co-morbidity, and health resource expenditures and utilization from a representative sample of the US population (n=32,000). Knowledge from the research portion of this training grant will result in six planned manuscripts and form the basis of an R01 application to test the hypothesis GSRH collected using an electronic health record is a valuable tool to effectively and efficiently improve health care delivery for disadvantaged populations. Skills acquired through this career development award will enable Dr. Karen DeSalvo to launch a successful, independent career in applied health services research focusing on interventions to improve the health of disadvantaged populations. [unreadable] [unreadable] [unreadable] [unreadable]